AB0569 FRECUENCY, TYPE AND DETERMINANTS OF COGNITIVE DEFICIT IN A COLOMBIAN COHORT OF PATIENTS WITH SLE
Authors: M. Rubio Rivera, Y. Medina, L. Duarte, O. Ayala, E. Ruiz, C. Rodíguez, C. Rodríguez
Journal: Annals of the Rheumatic Diseases (2022)

Background Cognitive deficit is part of the neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) (1). SLE patiens have 2.8 times more risk to develop cognitive deficit (2) and the prevalence is unknown among this population, with variable data from 5% to 80% (3). ACR (American Collegue of Rheumathology) recomends a specific neuropsychological battery (4), but many of the published studies uses variables diagnostic tests. Cardiovascular comorbidities and the use of certain immunosuppressive are involved in the development of cognitive deficit and may be confusors at the time of diagnosis (5). Cognitive deficit affects the quality of life and predisposes to the development of dementia (6). In our setting, the frequency of cognitive deficit as a manifestation of neuropsychiatric SLE is unknown. Determining conditions of it are unknown as well. Objectives 1.To define the frequency and degree of cognitive deficit in a cohort of patients with SLE 2.To describe associated factors (including quality of life and depression). Methods This was a cross-sectional observational study with 94 patients with SLE. The presence of cognitive deficit was established through a screening test (MoCA test). The diagnosis was confirmed through a battery of specific neuropsychological tests that were performed to patients with abnormal MoCA test. Quality of life was assessed using the LupusCol questionnaire wich is a validated scale for for measuring quality of life in SLE Colombian population. To measure the presence of depression we use the Beck inventory, this scale is also validated in SLE population. An exploratory analysis of the variables was performed and differences were established. A multivariate analysis was performed to find the variables associated with the cognitive deficit. Results Of the 94 patients, 90 (95.7%) were women. Of the 94 patients, 43 (51.2%) presented some degree of depression. The median for the loss of quality of life was VIII 21.03% (IQ 10.2 - 40.3). 35 (37.2%) patients had abnormal screening test. Specific neuropsychological tests were applied to 31 (90%) and of those, 11 patients (12.2%) presented a cognitive deficit. An association between cognitive deficit with a greater deterioration in quality of life was found (OR 1.05, 95% CI 1.01,1.09). Conclusion The frequency of cognitive deficit is important. There is an association of cognitive deficit with worse scores in quality of life. In addition, it was found that half of the patients presented some degree of depression. The comprehensive assessment of patients with SLE should include the evaluation of cognitive deficit and depression, because of their impact in quality of life, among other clinical aspects. References [1]Liang MH, Corzillius M, Bae SC, Lew RA, Fortin PR, Gordon C, et al. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599–608 [2]Rayes H Al, Tani C, Kwan A, Marzouk S, Colosimo K, Medina-Rosas J, et al. What is the prevalence of cognitive impairment in lupus and which instruments are used to measure it? A systematic review and meta-analysis. Vol. 48, Seminars in Arthritis and Rheumatism. 2018. p. 240–55. [3]Kello N, Anderson E, Diamond B. Cognitive Dysfunction in SLE : a case for initiating trials. Arthritis Rheumatol. 2019;71(9):1413–25 [4]Kozora E, Ellison MC, West S. Reliability and validity of the proposed American College of Rheumatology neuropsychological battery for systemic lupus erythematosus. Arthritis Care Res. 2004;51(5):810–8. [5]Waterloo K, Omdal R, Mellgren SI, Husby G. Neuropsychological functions in systemic lupus erythematosus: A comparison with chronic whiplash patients. Eur J Neurol. 1997;4(2):171–7. [6]Kanapathy A, Nik Jaafar NR, Shaharir SS, Chan LF, Rozita M, Ch’ng SS. Prevalence of cognitive impairment using the Montreal Cognitive Assessment questionnaire among patients with systemic lupus erythematosus: a cross-sectional 53 study at two tertiary centres in Malaysia. Lupus. 2019;28(7):854–61. Disclosure of Interests None declared